Rheumatic heart disease: how big is the problem?

Malaysia is progressing very rapidly in all aspects of life. It is fast developing and very soon it will be·a fully developed country. Many dangerous diseases, especially those of infectious aetiology have been eradicated and controlled. However, there are other diseases which are quite prevalent and result in high morbidity and mortality .. Cardiovascular diseases are good examples of these, and they are escalating in their prevalence. They are the leading cause of death in many countries of the world and in Malaysia they rank as the number one cause of death since the beginning of the last decade!. Among the cardiovascular diseases, coronary artery disease is the top killer. Systemic arterial hypertension comes next and valvular heart disease is the third killer of which rheumatic fever is the main caUse. Of all new patients referred .to the adult cardiac clinic in Hospital Universiti Sains Malaysia between 1991-1992, the commonest diagnosis made was rheumatic valvular heart disease2•